Invasion of the Stomach Bug- Our Trip to the E.R.

(Allow me to apologize for my poor drawing skills.
Our resident artist is out today.)

Our house has been invaded by this stupid stomach bug, and it's hit some of the kids more than the others. We ended up having to take our 7 year old to the emergency room. We were worried about dehydration and her increasing stomach pain. Before we left, I explained to her that she might have to get stuck with a needle (I.V.) so that they could get some fluids in her. I even packed a little bag, in case I had to stay the night with her. This was not something we were looking forward to. At. All.

To my surprise, we were in and out of the E.R in 3 hours! She was able to see the doctor in the triage room, he gave her some anti-nausea medicine and some apple juice. He explained to me that if this helped her to keep the fluids down, then there would be no need to give her an I.V. Needless to say, my daughter and I were both very happy about that! We went back to the waiting room and doodled pictures in a notebook that I brought. She was doing great! After about an hour, she asked me for more juice. She even told me she was starting to feel a little hungry! I was ecstatic! This was the firs time in three days that she has felt well enough to want food or drink. I went to the nurse to ask if it was ok for her to have more juice. The nurse got her more, and looked up her chart. Her test results were back and it was pretty much confirmed that all she had was a stomach bug, and not anything worse. The doctor came out soon after, gave me an RX for the anti-nausea medicine, talked to me a bit, and we were on our way!

I don't know if you are like me, but when my kids get sick, I suddenly forget everything that I know when it comes to treating them. The doctor gave me some very useful information sheets. I am putting them in my medicine chest (a cool little tackle box), so that they are easy to find when the next stomach bug invades us. The info is so good, that I thought I would share it here, too.
(I am simply sharing this information. Please do not use it in place of professional medical advice.)
The following  information is written and/or distributed by Sutter Hospitals.

Home Care for Children 2-5 Years Old:
First:
To treat vomiting and prevent dehydration, give small amounts of fluids at frequent intervals.

• Begin with ORS* (Oral Rehydrating Solution) at room temperature. Give 1-2 teaspoons every 1-2 minutes. Even if your child vomits, keep feeding as directed. Much of the fluid will still be absorbed.
• As vomiting lessens, give larger amounts of ORS* at longer intervals. Keep doing this until your child is making urine and is no longer thirsty (has no interest in drinking). Do not give your child plain water, milk, formula or other liquids until vomiting stops.
• If frequent vomiting goes on for more than FOUR HOURS with the above method, call your doctor.

Note: Your child may be thirsty and want to drink faster, but if vomiting, give fluids only at the prescribed rate. Too much fluid in the stomach will cause more vomiting.

Then:

• AFTER TWO HOURS with no vomiting, give small amounts of full strength formula, milk, ice chips, broth, or other fluids. Avoid sweetened juices or sodas. Increase the amount as tolerated.
• AFTER FOUR HOURS with no vomiting, restart solid foods (rice cereal, other cereals, oatmeal, bread, noodles, carrots, mashed bananas, mashed potatoes, rice, applesauce, dry toast, crackers, soups with rice or noodles and cooked vegetables). Give as much fluid as your child wants.
• AFTER 24 HOURS with no vomiting, go back to a normal diet.

Note: Some children may be sensitive to the lactose present in milk or formula, and symptoms may worsen. If that happens, use ORS* instead of milk or formula during this illness.

Follow Up with your doctor if your child does not show signs of improvement in the next 24-hours. 

GET PROMPT MEDICAL ATTENTION if any of the following occur:

• Increasing abdominal pain or constant lower right abdomen pain
• Repeated vomiting after the first 2 hours on fluids
• Occasional vomiting for more than 24 hours
• Continued severe diarrhea for more than 24 hours
• Blood in vomit or stool (black or red color)
• Reduced oral intake
• Dark urine or no urine for 8 hours, no tears when crying, "sunken" eyes or dry mouth
• Child is more fussy, drowsy, or confused than usual, or has a stiff neck or seizure
• Fever over 104.0 degrees F rectal, not better with acetaminophen (Tylenol) or ibuprofen (Motrin)
• New rash

*ORS is Oral Rehydrating Solution such as Pedialyte or Rehydralyte. You can get them from most drug stores and grocery stores without a prescription.

Home Care for 6 Years Old to Adult:

1. If symptoms are severe, rest at home for the next 24 hours.
2. Avoid tobacco and alcohol use, which may worsen symptoms.
3. Acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) may be used for fever or pain unless another medication was prescribed. [Note:  If the patient has cronic liver or kidney disease or ever had a stomach ulser or GI bleeding, talk with the doctor before using these medicines.] (Aspirin should never be used by anyone under the age of 18 who is ill with a fever. It may cause liver damage.)
4. If medicines for diarrhea or vomiting were prescribed, be sure they are taken only as directed.
5. If vomiting, drink small amounts of clear fluids (such as water, sports drinks, clear sodas) at frequent intervals to prevent dehydration. Start with 1-2 tablespoons every 10 minutes. Once vomiting stops, follow these guidelines:

DURING THE FIRST 12-24 HOURS follow the diet below:

• BEVERAGES: Sports drinks like Gatorade, soft drinks without caffeine, gingerale, mineral water (plain or flavored), decaffeinated tea and coffee.
• SOUPS: Clear broth, consomme, and bouillon
• DESSERTS: Plain gelatin (Jell-O), popsicles and fruit juice bars

DURING THE NEXT 24 HOURS:

• Hot cereal, plain toast, bread, rolls, crackers
• Plain noodles, rice, mashed potatoes, chicken noodle or rice soup
• Unsweetened caned fruit (avoid pineapple), bananas
• Limit fat intake to less than 15 grams per day by avoiding margarine, butter, oils, mayonnaise, sauces, gravies, fried foods, peanut butter, meat, poultry, and fish.
• Limit fiber; avoid raw or cooked vegetables, fresh fruits (except bananas) and bran cereals.
• Limit caffeine and chocolate. No spices or seasonings except salt.

DURING THE NEXT 24 HOURS:

The patient can gradually resume a normal diet as symptoms lessen.

FOLLOW UP with your doctor as advised if you are not improving over the next 2-3 days. 

GET PROMPT MEDICAL ATTENTION if any of the following occur:

• Increasing abdominal pain or constant lower right abdomen pain
• Continued vomiting (unable to keep liquids down)
• Frequent diarrhea (more than 5 times a day)
• Blood in vomit or stool (black or red color)
• Reduced oral intake
• Dark urine, reduced urine output
• Weakness, dizziness, fainting
• Drowsiness, confusion, stiff neck or seizure
• Fever over 101.0 degrees F for more than 3 days
• New rash